Dsm-V Depression (A Comprehensive Guide)

In this guide, DSM 5 depression, symptoms of depression along with the diagnostic criteria, causes, and treatment options for depression will be discussed.

What is Depression according to the DSM- V?

Depression or clinically known as major depressive disorder, according to the Diagnostic and Statistical Manual of Mental disorders, is a  serious mood disorder where people affected by it experience persistent feelings of sadness and hopelessness. 

Apart from these emotional distress, people with depression can also experience physical symptoms such as chronic pain, or changes in their behaviour such as social withdrawal or slowed movements.

For someone to be diagnosed with clinical depression, symptoms must be present for at least two weeks. Let us look at the various symptoms that must meet the criteria for a diagnosis of depression. 

What is the DSM criteria for Depression diagnosis?

The Diagnostic and statistical manual of Mental Disorders (5th ed) DSM-V outlines the following criterion to make a diagnosis of depression. 

The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. 

These symptoms should indicate change from normal functioning. 

  • Depressed mood most of the day, nearly every day- either by their own observation or observation made by others.
  • Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  • Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
  • Insomnia or hypersomnia. 
  • A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  • Fatigue or loss of energy nearly every day.
  • Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

To be diagnosed with depression, these symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning. 

These symptoms should also not be the result of substance abuse or another medical condition.

What are some of the changes in the DSM-5 criteria for depression?

The DSM-V which is the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), added two specifiers to further classify diagnoses:

Depression with mixed features- where manic symptoms are also present without meeting the full criteria of a manic episode.

Depression with anxious distress where there is a presence of anxiety that affects prognosis, treatment, and outcomes of treatment.

It is also to be mentioned that other than these two specifies, there has been no major changes in the diagnostic criteria for Major depressive disorder. 

What are the prevalence rates of depression according to the DSM-V?

According to the DSM-V the prevalence of MDD for a period of 12 months in the United States is 7% of the population where the age group of 18-29 year olds have a higher prevalence of depression- specifically 3 times higher prevalence than older adults above the age of 60.

The DSM-V also mentions that the preva;ance rates for depression is higher in females than in males- with a difference of 1.5-3 rates higher in women starting from adolescence than in men. 

What are the Risk factors and comorbidity risks?

Some of the risk factors that makes the development of depression or MDD more likely in individual include:

  • Temperament: High levels of Neuroticism related personality traits or temperament makes it more likely that a person will develop depression in the face of life stressors. 
  • Environment: Early life experiences which were negative such as parenting styles, trauma in childhood, lifestyles, poverty, peer environments put individuals who experience them at a higher risk of developing depression. 

However, it is to be mentioned that adverse events close to the development of an episode is not a reliable guide for prognosis or treatment development. 

  • Genetic and physiological risks: People whose immediate family has also been affected by the disorder has a higher risk- two to 4 percent higher risk to develop the disorder with heritability approvimatedly 40% higher and relative risks higher for early onset. 
  • Course modifiers: Major Non-mood disorder also makes the risk of developing depression higher. Such disorders include: anxiety, substance use, personality disorders. Other conditions such as chronic or disabling medication conditions also make the risks higher. 
  • Suicide risk: According to the DSM-V the possibity of suicdie is always present wit depression episodes and it is a consistent risk with the disorder especially in men having ahigher risk for completed suicde. 
  • Comorbidity risks for depression include anxiety, anorexia nervosa, OCD, Panic disorder,substance use disorders, borderline personality disorder, and bulimia. 

What are the functional consequences of Depression?

The impairments caused by depression are a result of its symptoms and the severity of the impairment differs on a spectrum. It can be mild to the point that people in contact with the affected individual do not notice or are unaware of it. 

It can also develop in severity to the point that the person affected are unable or do not have the capacity to attend to their basic self care needs or also can become catatonic with psychotic features, 

Individuals with depression who are treated in hospice or in medical settings tend to have more severe disability in their functions as compared to others who are treated in counselling settings. 

What are the treatments for depression?

The various treatments for depression include:

  • Medications prescribed by a physician such as Selective serotonin reuptake inhibitors (SSRIs), Serotonin and norepinephrine reuptake inhibitors (SNRIs), Tricyclic and tetracyclic antidepressants, Noradrenaline and dopamine reuptake inhibitors (NDRIs), Monoamine oxidase inhibitors (MAOIs). 

Each of these medications have potential side effects and should be taken under clear tested diagnosis and guidance of a medical professional.

  • Psychotherapy also known as talk therapy involves effective treatment where a person with disorder speaks to a trained therapist to help them identify and cope with their condition. 

Psychotherapy has many forms and techniques, which might take some time for a person with disorders to figure out what is best for them, However evidence suggests that CBT is one of the most effective treatments for depression.

  • Combined treatment of psychotherapy and pharmaceuticals have been found to be more effective than either stand-alone treatments for MDD. 
  • Light therapy is a form of treatment used in tandem with psychotherapy and pharmaceuticals where people are exposed to doses of white light in the face of major depressive disorder with seasonal patterns.
  • Electroconvulsive therapy (ECT) is used for people with severe depression and as a last resort when other forms of treatment have not worked out. Here, people with depression are treated with electrical currents that induce seizures, which has been found to be helpful for clinical depression. However, like other treatments, this form also has various side effects. 
  • Alternative therapies alongside traditional psychotherapy and medication such as meditation for stress and anxiety can help reorient patterns of responses to depression triggers. Acupuncture is also another form of alternative therapies for depression. 

Conclusion

In this guide we have discussed the DSM-V criteria for depression and the various risk factors and treatment strategies to help cope with depression. 

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.

Higuera. V, Everything You Need to Know About Depression (Major Depressive Disorder), Healthline, November 16th, 2021. https://www.healthline.com/health/depression

Frequently asked questions related to “dsm 5 depression”

What does the DSM 5 say about depression?

The DSM 5 lists criteria for depression and that the individual must be experiencing five of the symptoms for at least 2 weeks that cause severe impairment in various areas of their life.

What are mood disorders in DSM 5?

Mood disorders in the DSM-IV have been replaced by separated sections for Bipolar disorders and depressive disorders in the DSM 5.

The criteria for Bipolar disorders in DSM5 has remained unchanged however, three new depressive disorders have been included: namedly, disruptive mood dysregulation disorder, persistent depressive disorder, and premenstrual dysphoric disorder.

What is the DSM 5 code for major depression?

The DSM 5 code for Major Depression is 296.31.

What are the 5 DSM categories?

Five Mental disorder categories according to the DSM-V include::

  • Neurodevelopmental, Schizophrenia Spectrum and Psychotic Disorders, 
  • Bipolar and Related Disorders
  • Depressive Disorders
  • Anxiety Disorders
  • Obsessive-Compulsive and related disorders

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